儿童过敏性结膜炎与变应性鼻炎的相关性及鼻眼联合治疗的研究分析

The correlation of allergic conjunctivitis with allergic rhinitis and combined treatment of nasal and eye in children

目的探讨儿童过敏性结膜炎与变应性鼻炎的相关性及鼻眼联合防治的临床效果。方法回顾性分析2010年10月至2014年6月收治的300例儿童过敏性结膜炎与310例儿童变应性鼻炎患者的临床资料,首先对儿童过敏性结膜炎与变应性鼻炎的相关关系进行分析。然后将过敏性结膜炎合并变应性鼻炎患儿按照抽签方法随机地均分为对照组与观察组。对照组采用常规点眼的方法进行治疗,观察组则采用生理性海水鼻腔喷雾剂喷鼻联合人工泪液点眼进行治疗。对比观察两组患者临床疗效、治疗前后症状评分、泪膜破裂时间(BUT)及角膜荧光素染色评分、不良反应发生情况。结果 1300例过敏性结膜炎患儿中,50例(16.67%)并发变应性鼻炎;310例变应性鼻炎患儿中,59例(19.03%)并发过敏性结膜炎,二者差异无统计学意义(P>0.05);2109例同时并发两种疾病患儿,均进行眼结膜与鼻黏膜的刮片检查嗜酸性粒细胞,其中60例(55.05%)结膜刮片与67例(61.47%)鼻黏膜刮片检测到嗜酸性粒细胞,二者差异无统计学意义(P>0.05);3经治疗,观察组总有效率显著高于对照组(92.00%比72.00%)(P<0.05);4两组治疗后症状评分、BUT及角膜荧光素染色评分均较治疗前有显著改善,差异有统计学意义(P<0.05,P<0.01),且观察组治疗后上述指标均优于对照组,差异均具有统计学意义(P<0.05);5两组治疗过程中均未见不良反应发生。结论儿童过敏性结膜炎与变应性鼻炎具有一定的相关性,提示预防过敏性结膜炎在未来预防变应性鼻炎中应作为一项重要的纳入指标;生理性海水鼻腔喷雾剂喷鼻联合人工泪液点眼治疗儿童过敏性结膜炎合并变应性鼻炎的临床疗效显著,值得临床推广应用。

Objective To investigate the correlation of allergic conjunctivitis with allergic rhinitis and the effect of combined treatment of nasal and eye in children. Methods The clinical data of 300 children with allergic conjunctivitis and 310 children with allergic rhinitis treated from Oct,2010 to Jun,2014 in our hospital were retrospectively analyzed. First of all,the correlation of allergic conjunctivitis with allergic rhinitis was analyzed. Then,the children were randomly divided into two groups,control group received routine eye treatment,observation group treated with bright nose nasal spray and artificial tears. The clinical effect,symptom scores,tear film break- up time（ BUT） and corneal fluorescein staining（ FLS） scores,and the occurrence of adverse reactions were compared between two groups. Results 1 Of 300 children with allergic conjunctivitis,50（ 16. 67%） complicated with allergic rhinitis; of 310 children with allergic rhinitis,59（ 19. 03%） complicated with allergic conjunctivitis,the difference was not significant（ P 0. 05）. 2 Scraping examination of conjunctiva and nasal mucosa was performed in 109 children concurrent with the two diseases. Eosinophils was found in 60 conjunctiva scraping（ 55. 05%） and 67 nasal mucosa scraping（ 61. 47%）,the difference was not significant（ P 0. 05）. 3The total effective rate of the treatment in observation group（ 92. 00%） was higher than control group（ 72. 00%）（ P 0. 05）. 4Symptom scores,BUT and FLS scores were significant improved in both groups after treatment（ P 0. 05 and P 0. 01,respectively）; and better effect was observed in the observation group（ P 0. 05）. 5 No adverse reactions occurred in the treatment process of the two groups. Conclusion Allergic conjunctivitis and allergic rhinitis are related in children,indicating the prevention of allergic rhinitis should be considered for the prevention of allergic conjunctivitis. The treatment of bright nose nasal spray combined with artificial tears exhibits satisfactory effect for children with both allergic conjunctivitis and allergic rhinitis.